Prediction of small for gestational age newborns using ultrasound estimated and actual amniotic fluid volume: published data revisited

Aust N Z J Obstet Gynaecol. 2008 Apr;48(2):160-4. doi: 10.1111/j.1479-828X.2008.00830.x.

Abstract

Background: Intrauterine growth restriction (IUGR) is a complex problem in modern obstetrics. The presence of oligohydramnios is reported as an important diagnostic and prognostic factor in the management of a pregnancy complicated by IUGR.

Aim: To determine the predictive accuracy of sonographic and actual amniotic fluid volume (AFV) to identify small for gestational age (SGA; birthweight < 10%).

Methods: Before amniocentesis, the single deepest pocket (SDP) and amniotic fluid index (AFI) were obtained. The AFV was determined using a diazo-dye reaction. Thresholds for AFI, SDP and AFV were estimated using receiver-operating curves analysis and areas under the curves were used to assess predictive accuracy of these indices. Likelihood ratios (LR) were obtained.

Results: Among the 175 newborns, 16% had SGA. Compared to newborns with birthweight > 10%, all AFV indices were significantly lower (P= 0.001, P= 0.001 and P= 0.009 for AFI, SDP and AFV respectively) for SGA. The areas under the curves for all curves < 0.65 and the LR for all thresholds were < 5.0, reflecting poor diagnostic capabilities.

Conclusions: Despite observed lower AFV indices in SGA, neither sonographic examination nor determination of AFV is a reliable predictor of suboptimal growth.

MeSH terms

  • Adult
  • Amniotic Fluid*
  • Birth Weight*
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Oligohydramnios / diagnostic imaging
  • Predictive Value of Tests
  • Pregnancy
  • ROC Curve
  • Retrospective Studies
  • Ultrasonography, Prenatal*